R11, 2020-06-19

NOTE: U Sail Bermuda does not accept paper waivers, please submit electronically.

Covid-19 Health Declaration

Please complete our coronavirus (covid-19) health declaration within the 2 days prior to attending a course or first session each week. 

By completing this coronavirus (covid-19) health declaration, you agree that we can give this basic information listed below, should the Ministry of Health require it for contract tracing purposes.

Should you develop any symptoms at anytime during or after your course or session, please contact us at covidresponse@usailbda.com as we will need to inform the Ministry of Health for contact tracing.

 



If you have any of the following symptoms: fever (above 100.4 °F (38°C) ), tiredness, and dry cough then we advise you based on government guidelines to stay at home and you will be refused entry to the centre. Please see our ‘Coronavirus- Covid 19 section under our terms and conditions’ where you will be able to receive a credit for a future booking.

Please complete the following questions:

1) Are you currently suffering from any symptoms (fever (above 100.4 °F (38°C) , tiredness, and dry cough) of Coronavirus (covid-19) within the last 7 days of the course start date? 

2) Have you had any of your household members feel symptoms of fever (above 100.4 °F (38°C), tiredness, loss of taste and dry cough in the last 14 days?


Please sign below:

Participants' Signature

Click to Sign
Signature of Partcipant

Parent/Guardians' Signature (If participant is under 18):

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Signature of parent/guardian (if under 18)

Current Date Tue Sep 22, 2020

By checking here, you acknowledge you have read and understand the above terms, and are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.